The association between hand grip strength and rehabilitation outcome in post-acute hip fractured patients

  • Avital HershkovitzEmail author
  • Beloosesky Yichayaou
  • Ayelet Ronen
  • Gal Maydan
  • Natalia Kornyukov
  • Arie Burstin
  • Shai Brill
Original Article



Various factors have been shown to affect the rehabilitation outcome of hip fractured patients. Considering the decrease in muscle mass with aging and its impact on mobility, we hypothesized that a relationship exists between hand grip strength and rehabilitation outcome.


We retrospectively studied 373 post-hip fracture patients, admitted for rehabilitation. Muscle strength was measured by hand grip dynamometer. Main outcome measures: functional independence measure motor functional independence measure, motor functional independence measure effectiveness and length of stay). A favorable functional gain was defined as a motor Functional Independence Measure effectiveness score > 0.5. The Spearman correlation assessed the associations between hand grip strength and outcome measures. A multiple linear regression model tested whether hand grip strength was an independent predictor of discharge motor Functional Independence Measure scores and length of stay


Significant correlations were found between hand grip strength and functional outcomes. A significant independent association was found between hand grip strength and discharge motor Functional Independence Measure score after adjustment for confounding demographic and clinical variables. High hand grip strength on admission was significantly associated with a greater chance of achieving a favorable functional gain (OR 1.064, 95% CI, 1.01–1.13; p = 0.032). Hand grip strength was not found to be associated with length of stay.


Hand grip strength is independently associated with rehabilitation outcome in post-acute frail hip fractured patients. Initial screening for hand grip strength on admission may help identify patients who require an intensive resistance exercise program.


Hand grip strength Rehabilitation outcomes Older people Frail Hip fracture 



The authors thank Mrs. Phyllis Curchack Kornspan for her editorial services.

Author contributions

AH initiated the study, helped write the manuscript, was involved in data collection, and review of the literature. CA was involved with data collection and review of the literature. SB assisted in editing the manuscript and review of the literature. RN helped write the manuscript, review of the literature and was involved in data collection.

Compliance with ethical standard

Conflict of interest

All authors report no conflicts of interest. This work was not supported by any funding sources.

Statement of human and animal rights

This study was approved by the hospital’s Institutional Review Board (human and animals rights) #0198-18-RMC.

Informed consent

For this type of retrospective study informed consent is not necessary.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Avital Hershkovitz
    • 1
    • 3
    Email author
  • Beloosesky Yichayaou
    • 2
    • 3
  • Ayelet Ronen
    • 1
  • Gal Maydan
    • 1
  • Natalia Kornyukov
    • 1
  • Arie Burstin
    • 1
  • Shai Brill
    • 1
    • 3
  1. 1.Beit Rivka Geriatric Rehabilitation CenterPetach TikvaIsrael
  2. 2.Rabin Medical CenterBeilinson HospitalPetah TikvaIsrael
  3. 3.Sackler School of MedicineTel-Aviv UniversityTel AvivIsrael

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